Management of Lisfranc injuries of the foot | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 56, Issue 2, April 2021, Page 75-81 PDF (3.9 MB) | ||||
| DOI: 10.4103/eoj.eoj_65_21 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ali M. Elgioushy; Mohammed A. El Aziz Hassan; Gaballah A.-E. Gaballah | ||||
| Abstract | ||||
| Background The term ‘Lisfranc injury’ strictly refers to an injury where one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot centered on the second tarsometatarsal joint. The injury is named after Jacques Lisfranc de St. Martin (1790–1847), a French surgeon and gynecologist who first described the injury in 1815. ‘Lisfranc injury’ encompasses a broad spectrum of injuries, which can be purely ligamentous or involve the osseous and articular structures. They are often difficult to diagnose and treat, but if not detected and appropriately managed, they can cause long-term disability. Aim The aim of this work was to evaluate the proper management of lisfranc injuries and identify the best method of diagnosis and treatment. Patients and methods This is a prospective study that included 15 patients with Lisfranc injures of the foot who presented to the Emergency Department of Al-Azhar University Hospitals (Al Hussein and Sayed Galal Hospitals) between January 2016 and June 2017 and followed up for 3–9 months, with an average of 6 months. Fractures were classified according to the Myerson’s and Hardcastle classification. All patients were treated by emergency surgery by screws or Kirschner wires (K-wires). The American Orthopaedic Foot & Ankle Society (AOFAS) functional scale was used to assess results in the midfoot and patient satisfaction was also evaluated. Results After a mean 6 months of follow-up, the mean score on the AOFAS scale was 81.8, with a high level of satisfaction in nearly all patients. The results obtained with screw fixation were similar to those with K-wires. Conclusion Like most authors, the best results are obtained by the early reduction and fixation of the injury. The authors rule out nonoperative treatment and favor an ORIF procedure with Kirschner wires and screws, provided that the condition of the soft tissues allows it. The results obtained with K-wires were similar to those found in screw fixation, and anatomic reduction is the main predictor of outcome in patients with Lisfranc fracture dislocations. | ||||
| Keywords | ||||
| foot; fracture dislocation; Lisfranc | ||||
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